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What is chemical peeling?
It is a chemical surgery treatment that can be used to improve the appearance of the skin. An acid solution is applied to the skin separating layers of the epidermis (outer layer of the skin). The epidermis remains in place, acting as a biological dressing until it peels off and is replaced by the regenerated skin underneath. A deep peel penetrates further into the lower dermal layer of the skin.
The lesion caused by the acid is healed with the formation of new collagen. After the skin is healed the condition of the skin is rejuvenated. The new skin has a smoother texture, with fewer wrinkles, more even colour tone and pigmentation, with a improved appearance of scarred skin. The stronger the acid peeling the more of the skin is separated and peeled, allowing the rejuvenated skin to emerge. Depending on the strength of the peeling it can take between few days or even more than two weeks for the skin to heal.
What types of skin conditions can be treated with chemical peeling?
Chemical peel can be used effectively to reduce fine lines, in particular under the eyes and around the lips, as well as, wrinkles caused by sun damage, ageing and hereditary factors. All of which can be reduced or eliminated, slowing the effects of the ageing process.
The pigmentation of the skin, such as sun spots, age spots, liver spots, freckles, blotchiness (due to taking contraceptive pills), dull skin texture and colour, sun damaged skin and scaling patches can also improve after the chemical peel.
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The appearance of skin with mild scarring and some types acne scars can also be enhanced with chemical peel. This procedure cannot change pore size or remove broken vessels on the face, but it may help to improve the appearance of these conditions.
However, loose or sagging skin cannot be treated with chemical peeling, as it cannot eliminate the gravitational forces that generate loose skin. Bulges, severe scars and wrinkles do not improve with chemical peeling either, requiring other types of cosmetic surgery.
How is chemical peeling performed?
This technique can be applied to the face, neck, hands, arms and legs. There are three levels of chemical peeling that can be used: superficial, medium or deep. Within each level there are sublevels of strength, depending on the type and severity of the skin damage. The deeper the peeling is the longer it takes for the skin to heal.
A few months before undertaking the treatment, the dermatologist may do a test on a small area of the skin, to ensure it is a suitable treatment depending on how the skin reacts. It may also be necessary to stop certain medications and use some pre-conditioning cream to prepare the skin for treatment.
Just before applying the acid peeling, the eyes and the hair are protected and the skin is thoroughly cleaned with a cleaning agent to remove excess oils and dirt from the skin. Then, one or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid or carbolic acid are applied to the affected area of the skin. The dermatologist will choose the most appropriate acid or acids to use depending on the type of skin damage in order to achieve the desired results.
During the acid application the patient feels a warm or hot sensation for about five to ten minutes, followed by a stinging sensation. Depending on the strength of the peeling there can also be a mild to sever burning feeling. A deeper peel can be more painful and may need medication during or after the procedure.
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What to expect after the treatment?
After a superficial peeling the skin will have some redness followed by scaling, which tends to last between three to five days.
After a medium depth and deep peeling the skin can swell and turns red, sometimes blisters can occur after a deep peeling. The skin then turns brown and a crust is formed, at this point the skin feels tight and then it peels off in between seven to fourteen days.
Deep peeling may take longer to heal and a medical tape may be needed for dressing the skin.
What are the possible complications involved with chemical peeling?
In certain types of skin, there is a risk of temporary or permanent changing in the skin colour. This risk may increase with the intake of contraceptive pills, pregnancy or a family history of brown discoloration on the face.
Sometimes the redness on the skin can last for few months. There is also a low risk of scaring after the chemical peel, although this rarely occurs. In case this happens it can be treated successfully. There is also a risk of reactivating cold core or herpes simplex virus in patients who have had fever blisters in the past.
In order to avoid complications it is important to tell the dermatologist any cases of keloids, unusual scarring tendencies, extensive X-rays or radiation to the face and recurring cold sores, so that the correct precautions to the skin can be taken.
Caring for the skin after chemical peeling
A good care of the skin after a chemical peel is important for the recovering of the skin and helps to maximise the benefits and reduce the chances of adverse events.
After the chemical peel it is important to avoid expose the skin to sunlight, while the skin is healing, as the new skin is very sensitive and can be easily injured. After that sunscreens must be used to prevent the lesions from reappearing.
In order to help the skin to recover the dermatologist will prescribe an after care, including a specific topical cream to avoid infection, a non-drying cleanser, moisturiser and a non-chemical sunscreen.
You need to have a thorough evaluation with your dermatologist before deciding on a treatment based on chemical peel.
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